One Year Limit on Billing for Medicare Claims
Effective immediately, any Medicare Fee-For-Service claim with a date of service on or
after January 1, 2010, must be received by your Medicare contractor no later than one
calendar year (12 months) — or Medicare will deny the claim. Yes, one calendar year.
For example, if the service date is August 27, 2010, the claim must be received by your
Medicare contractor no later than August 27, 2011— or Medicare will deny the claim.
What about claims before Jan. 1, 2010?
If you have Medicare Fee-For-Service claims with a service date from Oct. 1, 2009
through Dec. 31, 2009, those claims MUST be received by Dec 31, 2010 or Medicare will
deny them. Claims with services dates from Jan. 1, 2009 to Oct. 1, 2009 keep their
original Dec. 31, 2010 deadline for filing.
Unsure about date of service?
When claims for services require reporting a line item date of service, the line item date
will be used to determine the date of service; for other claims, you should use the “from”
date on the claim statement to determine the date of service.
More questions? For additional information about the new maximum period for claims
submission filing dates, contact your Medicare contractor or see the CMS website
and follow the links to MLN Matters Articles and download the full article on this subject,
#MM6960. (Link to article attached below.)
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